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QNXT Program Manager
Job Location:
Job Location:
Long Beach, NY - USA
Monthly Salary:
Not provided by the employer
Monthly Salary:
Posted:
8 September 2026 (7 hours ago)
Posted:
Application Deadline:
6 December 2026
Application Deadline:
Vacancies:
1 Vacancy
Vacancies:
Job Summary
Description:
The Program Lead QNXT Implementation is accountable for the successful implementation of the Claims workstream within a large-scale QNXT core platform transformation including migration from the current IKA platform. This role leads the end-to-end planning execution governance and delivery of all claims-related implementation activities. The Program Lead will collaborate closely with product managers supporting Claims Provider Data and Configuration including provider contracts benefits utilization management and business rules and capitation.
The ideal candidate brings strong healthcare payer claims expertise QNXT or comparable core administrative platform experience and a proven ability to lead complex cross-functional implementations. This individual will ensure deliverables are completed accurately and on schedule risks and dependencies are actively managed teams remain aligned and accountable and the organization is prepared for testing cutover go-live and stabilization.
What You Will Do:
The Program Lead QNXT Implementation is accountable for the successful implementation of the Claims workstream within a large-scale QNXT core platform transformation including migration from the current IKA platform. This role leads the end-to-end planning execution governance and delivery of all claims-related implementation activities. The Program Lead will collaborate closely with product managers supporting Claims Provider Data and Configuration including provider contracts benefits utilization management and business rules and capitation.
The ideal candidate brings strong healthcare payer claims expertise QNXT or comparable core administrative platform experience and a proven ability to lead complex cross-functional implementations. This individual will ensure deliverables are completed accurately and on schedule risks and dependencies are actively managed teams remain aligned and accountable and the organization is prepared for testing cutover go-live and stabilization.
What You Will Do:
- Serve as the accountable program lead for the QNXT Claims implementation with end-to-end responsibility for planning execution issue resolution and successful migration from IKA.
- Develop and manage the integrated claims implementation plan across business operations configuration data testing training operational readiness and cutover activities.
- Establish clear milestones deliverables dependencies accountable owners and completion criteria.
- Coordinate alignment across Claims Provider Data and Configuration workstreams including provider contracts benefits utilization management and business rules and capitation.
- Ensure the future-state solution supports accurate claims adjudication pricing payment and issue resolution.
- Partner with future-state designers internal subject matter experts technology teams product managers implementation consultants and vendors.
- Translate future-state workflows and strategic objectives into clear business requirements operating model changes implementation priorities and executable plans.
- Own claims implementation governance including status reporting RAID logs decision logs escalation management and stakeholder communications.
- Ensure claims-related deliverables are accurate complete and traceable including requirements process designs configuration inputs data-conversion needs test scenarios defect-resolution plans readiness criteria and go-live support materials.
- Coach and coordinate program managers operational leaders and subject matter experts by establishing clear ownership and driving accountability for commitments and outcomes.
- Manage daily collaboration with implementation consultants and vendors to ensure scope timelines deliverables and design decisions align with business objectives and enterprise governance standards.
- Lead preparation for system testing defect triage mock conversions operational readiness cutover go-live and post-implementation stabilization.
- Validate defect-remediation plans operational contingency plans and readiness criteria before implementation milestones are approved.
- Identify execution risks workflow gaps and dependency failures early and implement corrective actions that protect the timeline quality claims accuracy and stakeholder confidence.
- Supportvision and organizational goals while exploring how AI can improve operations and service delivery.
- Perform other duties as assigned.
You Will Be Successful If:
- You can take full ownership of a complex claims implementation and maintain accountability from planning through go-live stabilization.
- You understand the healthcare payer claims lifecycle and the operational and system components required for accurate adjudication pricing payment and issue resolution.
- You can align senior leaders operational teams subject matter experts technology partners consultants and vendors around common priorities and timelines.
- You can build and maintain integrated workplans RAID logs decision logs governance routines and executive-level status reporting.
- You can translate strategy and future-state designs into clear requirements priorities owners and actionable implementation plans.
- You are comfortable leading in a fast-paced ambiguous and high-stakes transformation environment.
- You can identify risks evaluate tradeoffs resolve blockers and make sound decisions when information is incomplete.
- You balance long-term transformation objectives with day-to-day operational realities.
- You drive disciplined execution while coaching teams improving performance and holding stakeholders accountable.
- You demonstrate strong program leadership strategic planning executive communication stakeholder management risk management and organizational change leadership.
What You Will Bring:
- Bachelors degree in Business Health Administration Information Systems or a related field or an equivalent combination of education and relevant experience.
- Masters degree in Business Administration Public Health Health Administration Information Systems or a related field preferred.
- At least six years of related experience within a health plan healthcare organization or related industry.
- Strong knowledge of healthcare payer claims operations and the end-to-end claims lifecycle.
- Experience leading large cross-functional system implementations or business transformations involving claims operations configuration data testing and operational readiness.
- Working knowledge of QNXT or a comparable core administrative platform.
- Understanding of how claims processing interacts with provider data benefits provider contracts utilization management and business rules capitation and other upstream and downstream functions.
- Experience with business requirements process design data conversion system testing defect triage mock conversions cutover planning go-live readiness and post-launch stabilization.
- Experience managing implementation consultants vendors product managers subject matter experts and cross-functional project teams.
- Strong facilitation communication coaching influencing and stakeholder-management skills.
- Strong analytical problem-solving risk-management and decision-making abilities.
- Demonstrated experience driving accountability and team performance in complex transformation programs.
- Advanced proficiency with Microsoft Word Excel PowerPoint Outlook Teams Access Visio and SQL.
About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical and operations management enterprise project management professional services and software consulting. We help our clients increase operational efficiency by delivering innovative solutions to their most complex business challenges.
Our approach has always been simple: think and act like the customers who need us and deliver what larger organizations cannot: tangible results that provide immediate value at a highly competitive rate. Your success matters and we know it.
Thats Impresiv!
Required Experience:
IC
